TORNA ALL’ELENCO

Epidemiology of acromegaly in Italy in Endocrine Abstracts

2010
AOU San Luigi di Orbassano

Tipo pubblicazione

Conference Abstract

Autori/Collaboratori (8)Vedi tutti...

Malchiodi E

Arosio M

Borraccino A


et alii...

Abstract

Aim of this study is to present preliminary epidemiological data on a population of 1512 acromegalic patients attending 22 tertiary centers in Italy from 1980 to 2002. At our knowledge this is the first large-scale epidemiological Italian study on acromegaly. Gender was 624 (41.2%) men and 888 (58.8%) women. Mean age at diagnosis was 45±13 years, 43±13 for men and 47±13 for women. Median estimated duration of acromegaly before diagnosis was 74 months (range: 36-144). 28% of cases were micro-adenomas and 68.6% macro-adenomas, the lattest being intrasellar in 41.2% of patients. At baseline GH were over 50 ?g/liter in 15.7% of patients, between 50 and 2.5 ?g/liter in 73.7% and under 2.5 ?g/liter in 1%. Data were not available in 9.6% of patients. Two patients had GH nadir during OGTT below 1 ?g/liter but elevated IGFI. Pre-treatment IGFI was available in 67.3% patients. Hyperprolactinemia was observed in 251(19%) patients (2/3 of whom women) and TSH hypersecretion in 9 (0.7%). 392 patients (25.9%) had one or more pituitary deficiencies: 4.1% hypoadrenalism, 8.1% hypothyroidism, 16.4% hypogonadism and 0.6% diabetes insipidus. 32.2% of patients presented hypertension, 16.2% diabetes mellitus, both diagnosed at a younger age than in general population and more frequent in women. Surgery represented first treatment in 53% of patients, pharmacological therapy in 45.9% and radiotherapy/radiosurgery in 0.8%. Only 34.3% of subjects underwent just one treatment, other patients had multiple therapies in particular: two treatments in 47.9%, three in 16.4% and four in 1.2%. At the end of the study 932 (62.6%) patients resulted in remission, of whom 399 (43.7%) currently on pharmacological treatment. 61 patients died: the main causes were vascular disease and malignancies. For vascular disease women had a major mortality for cerebral disease (20 versus 4%) while men for cardiac disease (38 versus 28%).

Keywords

hypertension; diabetes insipidus; hypogonadism; heart disease; hypothyroidism; hypophysis; epidemiological data; adenoma; microadenoma; vascular disease; drug therapy; population; diagnosis; female; patient; epidemiology; endocrinology; Italy; acromegaly; thyrotropin; hyperprolactinemia; diabetes mellitus; surgery; therapy; remission; mortality; gender;